| Entity Name: | GRANT COMMUNITY RESIDENTIAL HOME INCORPORATED |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 08 Jan 2019 (6 years ago) |
| Document Number: | P19000001579 |
| FEI/EIN Number | 82-3880748 |
| Address: | 2252 WRIGHT ST., UNIT A, FORT MYERS, FL, 33916, US |
| Mail Address: | 2252 WRIGHT ST., UNIT A, FORT MYERS, FL, 33916, US |
| ZIP code: | 33916 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1457853798 | 2018-03-02 | 2018-03-02 | 2252 WRIGHT STREET (A), FORT MYERS, FL, 33916, US | 2252 WRIGHT STREET (A), FORT MYERS, FL, 33916, US | |||||||||||||||||
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| Phone | +1 239-935-9247 |
| Fax | 2394660142 |
Authorized person
| Name | MR. JAHPHET Y GRANT |
| Role | AHCA PROVIDER |
| Phone | 2399359247 |
Taxonomy
| Taxonomy Code | 172V00000X - Community Health Worker |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| GRANT JAHPHET Y | Agent | 2252 WRIGHT ST., UNIT A, FORT MYERS, FL, 33916 |
| Name | Role | Address |
|---|---|---|
| GRANT JAHPHET Y | President | 2252 WRIGHT ST., UNIT A, FORT MYERS, FL, 33916 |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J24000066322 | TERMINATED | 1000000978154 | LEE | 2024-01-23 | 2044-01-31 | $ 7,343.14 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, FORT MYERS SERVICE CENTER, 2295 VICTORIA AVE STE 270, FORT MYERS FL339013871 |
| J24000066330 | TERMINATED | 1000000978155 | LEE | 2024-01-23 | 2034-01-31 | $ 432.49 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, FORT MYERS SERVICE CENTER, 2295 VICTORIA AVE STE 270, FORT MYERS FL339013871 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-21 |
| ANNUAL REPORT | 2023-01-07 |
| ANNUAL REPORT | 2022-04-13 |
| ANNUAL REPORT | 2021-04-22 |
| ANNUAL REPORT | 2020-01-24 |
| Domestic Profit | 2019-01-08 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
